The Right to Health Cluster of the USAID/SCALE project anchored  by the Centre for Social Justice has organized the validation meeting for the policy brief on the full implementation of the National Health Insurance Authority (NHIA) Act in Abuja. Similar meetings were held in Sokoto, Adamawa, Nasarawa, Imo, Ekiti, Bauchi and Rivers where the project is being implemented.

The policy briefs established the link between health insurance and universal health coverage, as well as the reasons for making health insurance compulsory. The policy brief reviewed key provisions of the NHIA Act  and state legislations on contributory health and health insurance. It ended with recommendations on increasing health insurance coverage and improving the implementation of health insurance programmes.

In a keynote address by Egharevba Joy DGM Legal, NHIA, highlighted novel provisions of the NHIA Act, 2022 and the steps taken by the Authority to create public sensitization on the provisions of the Act.  She urged everyone to bring forward recommendations that will assist in achieving the objectives of the Authority, which is to promote, regulate and integrate health insurance schemes for the attainment of Universal Health Coverage (UHC).

Presenting the policy document, CSJ’s Lead Director highlighted simple public health measures to be taken by the population to reduce illnesses and promote good health. This will reduce the financial burden on the government and the out-of-pocket medical expenses on the population.

In Part 1 of the policy document, CSJ provides a description of the idea  and philosophy of health insurance. Part 2 articulates Universal Health Coverage (UHC) and its key components including coverage of the entire population, full spectrum of health services according to need and financial protection from direct payment of health services when consumed. The link between health insurance and UHC is explored in Part 3 while Part 4 dwells on reasons for making health insurance compulsory. The reasons include achievement of UHC, financial risk protection in accessing healthcare, equity in financing healthcare, facilitating the implementation of the minimum core state obligation on health and reducing the financial burden on government.

Part 5 reviews the key operative provisions of the NHIAA. The provisions reviewed include the establishment of the NHIAA, the establishment and powers of the governing council, the establishment of state health insurance and contributory schemes and participation in health insurance to be compulsory. Others are qualifications for operating a private health insurance scheme, licensing and accreditation, the Vulnerable Group Fund (VGF), implementing the Basic Health Care Provision Fund (BHCPF), contributions under health insurance schemes, registration of employers and employees, etc.


Part 6 deals with critical issues arising from the NHIAA and current practice including the fact that the governing council is yet to be established, the compulsive nature of health insurance is yet to kick in, operationalization of state health insurance schemes and the VGF, enlightenment and sensitization, database of vulnerable persons, transparency and accountability as well as the funding of the BHCPF. Part 7 is the conclusions while Part 8 is the recommendations. The summary of the recommendations is as follows: Constitute the Governing Council of the NHIA, operationalise the Compulsory Health Insurance Regime through administrative sanctions and an amendment of the Act to provide sanctions for non-compliance, engage in Massive enlightenment and sensitization and operationalize State Health Insurance and Contributory Schemes.


Other include a call to operationalize the Vulnerable Group Fund in accordance with S.25 of the NHIA through  the health insurance levy, SIN taxes and a special intervention fund, establish and Continually update a database of vulnerable persons, contributions by federal employees, improve accountability and transparency and properly Fund Basic Health Care Provision Fund to meet the statutory provision of not less than 1% of the CRF and this should be provided as a statutory transfer, instead of being a service-wide vote or just a mere vote under the Ministry of Health.